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Multicenter Study
. 2011 Dec;51(6):867-75.
doi: 10.1093/geront/gnr066. Epub 2011 Jun 30.

Resident-directed long-term care: staff provision of choice during morning care

Sandra F Simmons  1 , Annie Rahman, Linda Beuscher, Victoria Jani, Daniel W Durkin, John F Schnelle
Affiliations
Multicenter Study

Resident-directed long-term care: staff provision of choice during morning care

Sandra F Simmons et al. Gerontologist. 2011 Dec.

Abstract

Purpose: To develop an observational protocol to assess the quality of staff-resident communication relevant to choice and describe staff-resident interactions as preliminary evidence of the usefulness of the tool to assess current nursing home practices related to offering choice during morning care provision.

Design and methods: This study included 73 long-stay residents in 2 facilities. Research staff conducted observations for 4 consecutive morning hours during targeted care activities (transfer out of bed, incontinence, dressing, and dining location). Observations were conducted weekly for 12 consecutive weeks. Staff-resident interactions were measured related to staff offers of choice and residents' responses.

Results: Interrater agreement was achieved for measures of staff offers of choice (kappa = .83, p < .001), type of choice provided (kappa = .75, p < .001), and resident requests related to choice (kappa = .72, p < .001). Observations over 2,766 care episodes during 4 aspects of morning care showed that staff offered residents choice during 18% of the episodes. Most observations (70%) were coded as staff offering "no choice."

Implications: Nursing home staff can use a simplified version of this standardized observational tool to reliably measure staff-resident interactions related to choice during morning care provision as a first step toward improving resident-directed care practice.

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Figures

Figure 1.
Figure 1.
Supervisor observational tool: offering choice to residents.
Figure 2.
Figure 2.
Instructions for the supervisor observation form.
See this image and copyright information in PMC

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